Kernicterus is a rare complication of neonatal jaundice, caused when the bilirubin level in the blood rises to such a level that it crosses the blood-brain barrier, causing damage to the brain and spinal cord. Our clients repeatedly told the community midwives that attended after their baby’s birth that they thought he was jaundice, pointing out that the whites of the baby’s eyes had become yellow.
The midwives failed to heed the parents’ concerns and relied on visually looking at the baby to see whether they felt he was excessively jaundice and decided that he was not. The baby was not tested for jaundice using a bilirubinometer (a simple device, commonly carried by community midwives), nor was he referred to the GP or hospital for assessment. Within a couple of days, following a seizure, our Clients’ baby had to be rushed to hospital.
He was admitted to the Neonatal Intensive Care Unit and given an exchange blood transfusion (where affected blood is taken from the baby and replaced with unaffected blood), in an attempt to reduce the level of bilirubin circulating in his body. Unfortunately, further mistakes were made during the blood transfusion, more blood was taken than was put back in, leading to the baby not having sufficient blood circulating in his body.
Realising that the baby needed more specialist care, the Hospital transferred him to a second hospital, for more specialist treatment. Sadly, the baby died shortly after admission to the second hospital.
The family were critical of the care their baby received in that:
- A visual check is never enough to determine how severe jaundice is.
- In this case, the baby was of African descent and so reliance on a visual check alone was even more dangerous.
- Community midwives should have tested jaundice levels in the community using a bilirubinometer (a handheld device that scans the surface of the skin to determine the level of bilirubin in the blood).
- If a bilirubinometer was not available in the community, the baby should have been referred to his GP, or hospital for further investigation.
- The exchange transfusion was performed negligently, resulting in the baby having a lower than usual blood volume circulating in his system and the levels of bilirubin not being sufficiently diluted.
The family sought our help with representation at the Inquest and with a clinical negligence claim against the Hospital Trust (who were also responsible for the care provided by the community midwifery team).
The Trust admitted liability during the Inquest and confirmed to the Coroner that changes had been made to training of community midwives, Trust policies and procedure, to prevent a baby dying in similar circumstances in the future. The claim settled shortly after the conclusion of the Inquest.
S J Edney Solicitors obtained compensation of £35,000 for these clients in 2016